Significant New Guidelines: Antibiotic Treatment Duration Will Be Shortened

Anti to Antibiotics: A new guideline document issued by Clalit Health Services sets new directives for antibiotic treatment. According to the document, the duration of antibiotic treatment for some infections and the number of doses per day will now be reduced, to prevent the development of resistant bacteria.

The guidelines booklet is updated once every few years, in line with global medical trends. This year, it emphasizes reducing antibiotic treatment as much as possible.

It is crucial to understand that excessive use of antibiotics can generate resistant bacteria. Each year, thousands die worldwide due to antibiotic-resistant bacteria, created by the overuse of antibiotics.

Here are the new guidelines:

1. Throat and tonsil infection in children (tonsillitis) - The treatment with moxypen (amoxicillin) will be once a day, at a dose of 50 mg per kg of body weight. The duration of treatment remains the same: 10 days.

2. Pneumonia in adults - The treatment duration will be reduced to 5 days (instead of the previous 7 to 10 days), provided the patient's condition improves, the fever drops below 37.8 degrees, and blood pressure, heart rate, and blood oxygen concentration (saturation) are normal.

3. Urinary tract infections in adults - Avoid using the following antibiotics: ofloxacin and ciprofloxacin, unless there is no other choice and no better antibiotic is available. The first line of treatment for urinary tract infections will be macrodantin (nitrofurantoin).

4. Skin infection of type cellulitis - From now on, do not use the old antibiotic "augmentin," as it is a broad-spectrum antibiotic that can increase the development of resistant bacteria. Instead, treat cellulitis with ceforal (cefazolin).

5. Use the antibiotic "aznil" only when there is no suitable alternative, meaning when there is suspicion of a bacteria resistant to other antibiotics, or when there is sensitivity to other antibiotics. Here too, the main concern is the development of bacteria resistant to aznil, due to its overuse.

It should be noted that while the new guidelines apply only to Clalit members, they reflect a worldwide trend. Additionally, remember that Clalit is Israel's largest health maintenance organization, covering about half of the population.

About a week ago, an article published in the respected journal "British Medical Journal" claimed that in many cases, antibiotics can be stopped earlier if the patient feels well. Health researchers argued that overly prolonged use of antibiotics contributes to the development of drug-resistant bacteria, as does unnecessary use of antibiotics, such as for viral illnesses, or using antibiotics when the patient has already recovered.

According to the researchers, the instruction to always finish the antibiotics is incorrect and not based on evidence. They stated, "There is a need to conduct new studies to update the precise treatment duration required for each specific condition. The message is clear: take the smallest amount of medication according to need, and nothing beyond that."

The head of the expert team, Prof. Tim Peto, a clinical epidemiology expert at Oxford University, claims there is no evidence that stopping antibiotics a few days earlier will cause someone to become ill again. Current evidence indicates that it is safe to stop antibiotics before the predetermined time, and recurrence of the illness will not be due to early discontinuation of antibiotics.

The researchers clarify that antibiotic treatment should not be stopped without consulting the treating physician, and before the patient has recovered and returned to their baseline state. It is important to understand there are exceptional cases where certain types of antibiotics may cause the development of lethal bacterial mutations, and in such cases, treatment should not be stopped before the predetermined time.